Development of resistance is particularly compelling for fluconazole
in individuals with HIV disease. In such cases, ketoconazole and
itraconazole have been recommended as alternatives.
 The azoles are also used in the treatment of secondary oral
candidiasis associated with systemic predisposing factors and for
systemic candidiasis.

Koebner phenomenon
(appearance of new skin lesions on previously unaffected skin 2ndary to trauma). This phenomenon may also be of relevance
for, which is continuously OLP exposed to physical trauma during mastication and brushing.

Patients with lupus who are receiving anticoagulants, oral surgical
procedures are safe in patients taking warfarin with therapeutic
international normalized ratio (INR) ranges (2–3.5) and do not require
discontinuation of anticoagulation.

As a rule, a patient who has received a glucocorticoid in doses
equivalent to at least 20 mg a day of prednisone for more than 5 days is
at risk for hypothalamus–pituitary–adrenal (HPA) suppression.

a- limited cutaneous scleroderma (previously called CREST syndrome for
Calcinosis cutis, Raynaud’s phenomenon, Esophageal dysmotility,
Sclerodactyly, and Telangiectasia)

• 2- Raynaud's phenomenon (RP) which is the result of spasm of the blood
vessels of the fingers &toes, can be triggered by cold temperature or
stress. Symptoms of RP include:
• Paleness,
• Coldness,
• Pain & numbness of fingers &toes.
It is important to note that not all people with Raynaud’s phenomenon have
scleroderma.

calcium channel blockers are prescribed for moderate to severe Raynaud’s
phenomenon

• 6- Progressive or severe cutaneous involvement may be treated
initially with methotrexate alone, or in combination with
cyclophosphamide.
• 7- Severe disease may be treated with cyclophosphamide initially,
Cyclophosphamide is used to treat early lung disease with alveolitis.
8- Other drugs reduce inflammation & block damage immune
factors. رانويد فونمين

Pyoderma gangrenosum is a condition that causes tissue to become
necrotic, causing deep ulcers بالالسرتف كولايتس

Melanin is actually composed of eumelanin, which is a brown-black pigment,
and pheomelanin, which has a red-yellow color.

A successful therapeutic approach for the treatment of melasma
consists in the topical administration of a triple combination
product (4% hydroquinone, 0.05% tretinoin, and 0.01%
fluocinolone acetonide) along with photoprotection (SPF 30
sunscreen)

Diffuse mucocutaneous hyperpigmentation may be one of the
earliest manifestations of primary biliary cirrhosis.

A lower labial gland biopsy has been shown to be an easy and effective method for the
diagnosis of hemochromatosis.

Increased melanin pigment may be seen in the basal cell layer, whereas golden or brown-
colored hemosiderin can be seen diffusely scattered throughout the submucosal and salivary
gland tissues

منا البداية

Cold, clammy hands or bitten fingernails may be the first indication of abnormal anxiety in the child.

A callused or unusually clean digit suggests a persistent sucking habit.

Clubbing of the fingers or a bluish color in the nail beds suggests congenital heart disease.

Mouth opening (which is normally 40-45 mm)

Chin prominence is related to mandibular position.

Lips normally should be competent (touch each other lightly or with 0-1 mm of gap).

When the lips do not approximate each other at rest, they are termed as incompetent.

اول مايجي الطفل للعيادة ف اول فحص الك هو
Head hair neck hand
انتبهوا عليها ترا مهم

لازم تميّزون بين شغلتين كلًش مهمّات:
As the patient enter the dental clinic
هنا أجيّك الwalking,size,stature and gait

After the patient seated in dental chair
هنا يلّا أكدر أفحص الhead,hair,face,neck and hands